Healthy Skepticism Library item: 16140

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Publication type: news

Perrone M.
Pharma funding for medical classes draws scrutiny
The Associated Press 2009 Jul 30
http://www.dailycommercial.com/080309pharma

Full text:

A government watchdog will tell Congress Wednesday that the pharmaceutical and medical device industries’ billion-dollar spending spree for medical education is threatening the judgment of physicians across the country.
Nearly all U.S. physicians are required to take continuing education classes to keep their medical certification. Professional societies like the American College of Cardiology and dozens of others sponsor conferences each year on the latest treatments.
Over the past 10 years, drug and device companies have increased their funding for such meetings by over 300 percent, according to industry figures. Companies now provide more than half of the $2.5 billion spent annually on medical education.
An inspector for the Department of Health and Human Services will tell Senate lawmakers today that tighter restrictions are needed to keep pharmaceutical companies from using that money to steer physicians toward prescribing their drugs. While companies are not permitted to present at meetings, they can shape the discussions by pouring millions of dollars into select topics, according to the inspector.
“Continuing education requires enhanced safeguards to preserve the boundaries separating education from marketing,” states Lewis Morris, in prepared remarks obtained by the Associated Press. Morris is chief counsel for the HHS office of inspector general.
The Senate Aging Committee will hear from a half-dozen other witnesses Wednesday, most of whom oppose industry funding for medical education. Committee Chairman Herb Kohl, D-Wis., is pushing a bill that would require companies to disclose all payments to physicians over $100. Kohl and co-sponsor Sen. Charles Grassley, R-Iowa, hope to include their Physician Payment Sunshine Act in the health care bill taking shape in the Senate, which has been slowed by cost concerns.
The hearing comes as some of the most influential medical institutions begin turning away from company-funded medical education.
Earlier this year the American Medical Association said that medical education should ideally be funded by organizations that don’t have a financial stake in courting physicians – although it stopped short of recommending a ban on industry money. In April, the government’s Institute of Medicine said “a new system of funding” for medical education is needed.
Morris will recommend an independent organization to distribute education grants provided by the drug industry, effectively establishing a “firewall” between drug companies and the people who decide how their grants are used.
The Pharmaceutical Research and Manufacturers Association said Tuesday it has not taken a position on the idea.
“We’ve basically left it up to our individual member companies to make decisions about how they want to allocate resources,” said Diana Bieri, the group’s general counsel. She pointed out that the group has already revised its voluntary guidelines to recommend companies keep their education departments separate from their sales and marketing divisions, a distinction that previously didn’t exist at some companies.
The group’s members include Pfizer Inc., Merck & Co. Inc., Eli Lilly & Co. and most of the world’s other large pharmaceutical companies.
Whether companies will be willing to completely remove themselves from decisions about how their funds are used is unclear.
Under the current system – which allows companies to steer funds toward topics that deal with their products – companies can see a return of $3 in sales for every $1 spent on medical education, according to an industry study.
“Companies readily pay hundreds of millions of dollars annually to support ‘continuing medical education’ for one very simple reason – it sells their products,” states the Cleveland Clinic’s chair of cardiology, Dr. Steve Nissen, in prepared remarks. “Industry funded CME is not philanthropy, it is marketing.”
Nissen, a frequent critic of corporate influence over medicine, will argue that pharmaceutical-backed conferences on the latest – and often most expensive – treatments have contributed to the nation’s ballooning health care costs.
Kohl and Grassley are expected to make similar arguments as they push for their Sunshine Payment bill to be included in the health reform effort.